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Osteoarthritis, bone density, postural stability, and osteoporotic fractures: a population based study
G Jones1, T Nguyen, P N Sambrook
1Garvan Institute of Medical Research, St. Vincent's Hospital, University of New South Wales, Sydney, Australia.
The Journal of Rheumatology
|May 1, 1995
Summary
Osteoarthritis (OA) is linked to higher bone density but not increased fracture protection in older adults. Worsened balance and falls offset the bone density benefit, leading to similar fracture risks.
Area of Science:
- Gerontology
- Orthopedics
- Epidemiology
Background:
- Osteoarthritis (OA) is often associated with increased bone density.
- Limited prospective data exist on the relationship between OA and fracture risk.
Purpose of the Study:
- To investigate the relationship between self-reported OA, bone density, postural stability, and atraumatic fractures in adults over 60.
- To determine if higher bone density in OA patients translates to reduced fracture incidence.
Main Methods:
- Utilized data from the Dubbo Osteoporosis Epidemiology Study, a longitudinal population-based cohort.
- Assessed bone density via dual-energy x-ray absorptiometry (DXA).
- Measured postural stability using quadriceps strength and sway tests; ascertained fractures via interviews and radiographic reports.
Main Results:
- 25% of 1821 participants (mean age 69) reported OA.
- Subjects with OA exhibited higher bone density at the femoral neck and lumbar spine (p<0.05).
- OA patients showed increased body sway and decreased quadriceps strength, with no significant difference in overall fracture incidence (men OR 1.11, women OR 1.08).
Conclusions:
- Self-reported OA is not associated with protection against nonvertebral osteoporotic fractures.
- Increased fall tendency due to worsened postural stability negates the protective effect of higher bone density in OA patients.
- Findings suggest a complex interplay of factors influencing fracture risk in individuals with osteoarthritis.